Rizal, Philippines

TENTATIVE AND ASSESSMENT FORM

Campus : Rizal Academic Term : Third Academic Year : 2023-2024

Applicant No : BI202300509 Full Name : ALESSA ELSIE MENDEZ Sex : Female
FORMALEJO
Course : BSED_ENGLISH- Major : ENGLISH Year Level/Status : 1st-REGULAR
Home Address B
: SAPERIA STREET, CALUMPANG, BINANGONAN, RIZAL Contact Number : 09512750543

Subject/s Section Lab Units Lec Units Days Time and Date Room
OLSS02 LFBN133M003 0 3 MTH 06:00 am - 07:30 am May 10, 2024
OLFIL-02 LFBN133M003 0 3 MTH 07:30 am - 09:00 am May 10, 2024
OLVAL02 LFBN133M003 0 3 MTH 09:00 am - 10:30 am May 10, 2024
OLBPENGL01A LFBN133M003 0 3 MTH 10:30 am - 12:00 pm May 10, 2024
OLPROFED01 LFBN133M003 0 3 TF 06:00 am - 07:30 am May 10, 2024 BB2.13
OLPROFED02 LFBN133M003 0 3 TF 07:30 am - 09:00 am May 10, 2024 BB2.13
OLPROFED03 LFBN133M003 0 3 TF 09:00 am - 10:30 am May 10, 2024 BB2.13
OLPHYE003 LFBN133M003 0 2 F 11:00 am - 01:00 pm May 10, 2024 BNGYM1

Tuition Fee Laboratory Fee Miscellaneous Fee Special Subject Total Amount

2,990.00 0.00 2,270.00 0.00 5,260.00

Other Fees 100.00

LMS Fee 300.00
Student Portal Fee 300.00
Drug Test 200.00
Mailing Fee 60.00
Test Booklet 30.00
TOTAL Php 6,250.00

Cash Payment Installment Payment Schedule

Php 5,724.00 Amount Due Dates Late Payments Penalties
Downpayment 1,030.00 May 08, 2024 5% May 09 onwards
10% Cash Discount 1st Installment 1,315.45 May 16, 2024 5% Jun 02 onwards
2nd Installment 1,315.45 Jun 01, 2024 5% Jun 02 onwards
for FULL PAYMENT 3rd Installment 1,315.45 Jun 17, 2024 5% Jun 18 onwards
4th Installment 1,315.45 Jul 01, 2024
made on or before 5th Installment 584.65 Jul 16, 2024
TOTAL 6,876.45
May 07, 2024

I shall abide by all the rules and regulations now enforced or may be promulgated by the School Management System from time to time, likewise,
I agree to the cancellation of the credits I have earned in subjects and have enrolled under false pretensed.

REMINDER: Date & Time Accomplished

Upon completion and printing of this PRE-ENROLLMENT, payment of either in CASH or DOWN PAYMENT
04:50PM / 18 Apr 2024
MUST BE SETTLED WITHIN 48 HOURS otherwise class schedules will be automatically deleted.

Prepared by: WAINALYN REANZARES